Diagnostic characteristics and literature review of hepatic artery pseudoaneurysm after liver transplantation

Abstract

Objective To investigate the clinical diagnostic features of hepatic artery pseudoaneurysm (HAP) rupture with biliary tract hemorrhage after liver transplantation. Methods A case of HAP rupture with biliary tract hemorrhage who repeatedly underwent endoscopic retrograde biliary drainage (ERBD) due to biliary anastomotic stenosis after liver transplantation, admitted to Department of Liver Surgery of Zhongshan Hospital Affiliated to Fudan University was analyzed retrospectively, and the relevant literatures were reviewed. Results The patient was admitted for with jaundice for more than one month on July 6, 2017 after liver transplantation 4 years ago, and repeatedly underwent ERBD surgeries. The patient underwent percuteneous transhepatic cholangio drainage (PTCD) and the right hepatic artery imaging was found. Hepatic angiography confirmed the pseudoaneurysm was located in the right hepatic artery and it ruptured to the biliary tract. After embolization of HAP and PTCD, the symptoms of fever and jaundice were significantly improved. Conclusion After liver transplantation, patients with iatrogenic invasive treatment history and unexplained recurrent fever with persistent jaundice should be regularly followed up with computer tomography angiography (CTA) to exclude the possibility of hemobilia due to HAP rupture. Key words: Hepatic artery pseudoaneurysm; Liver transplantation; Magnetic resonance imaging; Angiography, digital subtraction